Background to the report

The NHS has around 1,500 hospitals in England, of which around 210 provide emergency care. Where hospitals are older or in deteriorating condition, there may be significant risks to patient and staff safety and high maintenance costs.

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In 2020, following years of under-investment, the Department of Health & Social Care (DHSC) committed to build 40 new hospitals by 2030 through the New Hospital Programme (NHP). Hospitals in the programme will be built to a standard design with the aims of increasing cost-effectiveness and quality, and utilising the construction industry in a more coordinated way.

Hospital construction had previously been funded centrally but designed and delivered locally by NHS trusts. The NHP is a joint endeavour between DHSC and NHS England (NHSE) to coordinate schemes centrally instead. DHSC has overall responsibility for the NHP and NHSE is responsible for its delivery.

Following the July 2024 general election, the new government carried out an internal review of the NHP and announced a new implementation plan in January 2025.

Scope of the report

This report provides an update on progress on our 2023 report and whether the programme is now deliverable under the new plan, it:

  • sets out the history of the programme, the new implementation plan announced in January 2025 and what the programme aims to achieve
  • examines the progress that has been made towards building new hospitals
  • examines how DHSC is managing risks to delivery, including the extent that the new plan addresses issues raised in our 2023 report and by the Public Accounts Committee

Video summary

Andy Morrison, the report’s director, summarises our findings.

Conclusion

New hospitals are badly needed after many years of under-investment and in the context of a large maintenance backlog. When we reported in 2023, we found that delivering 40 new hospitals by 2030 was not a realistic goal given the level of funding committed, limits on market capacity and progress to date. We also identified substantial risks to value for money, such as building hospitals that were too small.

The latest reset of the New Hospital Programme has put DHSC’s plan to build new hospitals on a more stable, long-term footing. The plan to standardise the construction of hospitals has the potential to bring benefits in reducing construction costs and delivering economies of scale over time. As well as benefiting the NHS this approach is likely to be more appealing to constructors to enter the market, provided there is a sustainable pipeline of work. There are clear lessons to be learned about the need for well-managed investment in the public estate.

The New Hospital Programme is ambitious in that it seeks to transform how hospitals perform. It is important that DHSC takes the time needed to get the design for new hospitals right, plans the programme well and then executes the plan efficiently. In particular, the seven schemes to replace hospitals built with RAAC need to be delivered as a matter of priority once a credible plan is in place.

The construction schedule over the next few years is challenging as schemes adapt to the new approach, and there are risks of delivery dates slipping and construction activity being squeezed into later spending review periods. This could lead to budgetary pressure on later waves of the programme. Close monitoring is needed and scheduling of schemes kept under review.

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Publication details

Press release

View press release (16 Jan 2026)

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